Horizontal Inequity in Access to Health Care in Four South American Cities
AbstractResumen El objetivo de este trabajo es analizar el grado de inequidad socioeconómica en el uso de servicios médicos de la población adulta mayor en cinco ciudades latinoamericanas (Buenos Aires, Ciudad de México, Santiago de Chile, San Pablo y Montevideo), en base a los datos de la Encuesta de Salud, Bienestar y Envejecimiento relevada entre 1999 y 2000 (SABE, OPS/OMS, 2001). El análisis imputa el ingreso equivalente del hogar a través de la utilización de las encuestas de hogares de los distintos países, y considerando una amplia serie de indicadores de acceso, calidad y uso de servicios de salud. Una vez estandarizado el uso de servicios por las necesidades de cuidados, se encuentran desigualdades socioeconómicas pro-rico en el uso de servicios preventivos en todas las ciudades, desigualdades en la realización de visitas médicas en Santiago y Montevideo, y desigualdades en la calidad de acceso a la atención en todas las ciudades salvo Montevideo. Las desigualdades socioeconómicas dentro de los sistemas de salud públicos o privados explican una mayor proporción de las desigualdades en el acceso a la atención. Nuestros resultados son informativos en el contexto de las políticas recientes destinadas a la aplicación de paquetes mínimos de servicios. Abstract The objective of this paper is compare socioeconomic inequalities in the use of healthcare services in four South-American cities: Buenos Aires, Santiago, Montevideo, and San Pablo. We use secondary data from SABE, a survey on Health, Well-being and Aging administered in 2000 under the sponsorship of the Panamerican Health Organization, and representative of the elderly population in each of the analyzed cities. We construct concentration indices of access to and quality of healthcare services, and decompose them in socioeconomic, need, and non-need contributors. We assess the weight of each contributor to the overall index and compare indices across cities. Our results show high levels of pro-rich socioeconomic inequities in the use of preventive services in all cities, inequities in medical visits in Santiago and Montevideo, and inequities in quality of access to care in all cities but Montevideo. Socioeconomic inequality within private or public health systems explains a higher portion of inequalities in access to care than the fragmented nature of health systems. Our results are informative given recent policies aimed at enforcing minimum packages of services and given policies exclusively focused on defragmenting health systems.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoArticle provided by UNIVERSIDAD DEL ROSARIO in its journal REVISTA DE ECONOMÍA DEL ROSARIO.
Volume (Year): (2011)
Issue (Month): ()
Contact details of provider:
Other versions of this item:
- Ana Balsa & Máximo Rossi & Patricia Triunfo, 2009. "Horizontal Inequity in Access to Health Care in Four South American Cities," Documentos de Trabajo (working papers) 1509, Department of Economics - dECON.
- Ana I. Balsa & Máximo Rossi & Patricia Triunfo, 2009. "Horizontal inequity in access to health care in four South American cities," Working Papers 131, ECINEQ, Society for the Study of Economic Inequality.
- I1 - Health, Education, and Welfare - - Health
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- I12 - Health, Education, and Welfare - - Health - - - Health Production
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- GARCIA-GOMEZ, Pilar & SCHOKKAERT, Erik & VAN OURTI, Tom & BAGO D’UVA, Teresa, 2012.
"Inequity in the face of death,"
CORE Discussion Papers
2012024, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- Wagstaff, Adam, 2002.
"Inequality aversion, health inequalities and health achievement,"
Journal of Health Economics,
Elsevier, vol. 21(4), pages 627-641, July.
- Wagstaff, Adam, 2002. "Inequality aversion, health inequalities, and health achievement," Policy Research Working Paper Series 2765, The World Bank.
- Robert E. Leu & Martin Schellhorn, 2004. "The evolution of income-related inequalities in health care utilization in Switzerland over time," Diskussionsschriften dp0413, Universitaet Bern, Departement Volkswirtschaft.
- Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
- Wagstaff, Adam & Van Doorslaer, Eddy & Watanabe, Naoko, 2001.
"On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam,"
Policy Research Working Paper Series
2714, The World Bank.
- Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
- Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 89-112, Spring.
- Hugh Gravelle, 2003. "Measuring income related inequality in health: standardisation and the partial concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 803-819.
- Adam Wagstaff & Eddy van Doorslaer, 2000. "Measuring and Testing for Inequity in the Delivery of Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 35(4), pages 716-733.
- van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December.
- Leu, Robert E. & Schellhorn, Martin, 2004. "The Evolution of Income-Related Inequalities in Health Care Utilization in Switzerland over Time," IZA Discussion Papers 1316, Institute for the Study of Labor (IZA).
- Bertranou, Fabio M., 1999. "Are market-oriented health insurance reforms possible in Latin America?: The cases of Argentina, Chile and Colombia," Health Policy, Elsevier, vol. 47(1), pages 19-36, April.
- Van Ourti T., 2002. "Measuring horizontal inequity in health care using Belgian panel data," Working Papers 2002034, University of Antwerp, Faculty of Applied Economics.
- Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "On the measurement of horizontal inequity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 169-205, July.
- Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
- Fiorillo Damiano & Sabatini Fabio, 2011.
"Quality and quantity: The role of social interactions in individual health,"
0073, Department of Communication, University of Teramo.
- Fiorillo, Damiano & Sabatini, Fabio, 2011. "Quality and quantity: the role of social interactions in individual health," AICCON Working Papers 84-2011, Associazione Italiana per la Cultura della Cooperazione e del Non Profit.
- Damiano Fiorillo & Fabio Sabatini, 2011. "Quality and quantity: The role of social interactions in individual health," Discussion Papers 2_2011, D.E.S. (Department of Economic Studies), University of Naples "Parthenope", Italy.
- Fiorillo, D; & Sabatini, F;, 2011. "Quality and quantity: the role of social interactions in individual health," Health, Econometrics and Data Group (HEDG) Working Papers 11/04, HEDG, c/o Department of Economics, University of York.
- Damiano, Fiorillo & Fabio, Sabatini, 2011. "Quality and quantity: the role of social interactions in individual health," MPRA Paper 29777, University Library of Munich, Germany.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Publicaciones Economía).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.